子宫阴道脱垂悬吊术ICD-9-CM-3编码解析

ICD-9-CM-3 coding analysis of hysterovaginal prolapse suspension

临床上针对子宫阴道脱垂经常采用的悬吊术有骶韧带悬吊术、髂耻韧带悬吊术、骶棘韧带悬吊术和盆筋膜腱弓悬吊术等。骶韧带悬吊术、髂耻韧带悬吊术、骶棘韧带悬吊术的目的是通过悬吊子宫、阴道直接或间接促使盆腔脱垂的器官复位。根据悬吊目的将临床手术名称转化为分类手术名称子宫悬吊术69.22或阴道悬吊术70.77/70.78。而针对膀胱膨出开展的盆筋膜腱弓悬吊术,经查阅文献,属于经阴道阴道旁修补术,不属于悬吊术范畴,因此编码应归类到70.51膀胱膨出修补术。子宫阴道脱垂悬吊术的编码难点在于需要深度掌握临床给出的悬吊术的本质和内涵,需要将临床手术名称转化为分类手术名称。因此子宫阴道脱垂悬吊术编码时不仅要详细阅读手术记录,还要临床医师和编码员共同沟通,查阅相关文献,认真根据术式精准查找编码,这样确保得到准确ICD-9-CM-3编码。

The commonly used suspensions for hysterovaginal prolapse include sacral ligament suspension,iliopectineal ligament suspension,sacrospinous ligament suspension and pelvic fascia tendon arch suspension.The purpose of sacral ligament suspension,iliopectineal ligament suspension,and sacrospinous ligament suspension is to reposition the prolapsed pelvic organs directly or indirectly by suspending the uterus or vagina.The clinical surgical names were converted into categorical surgical names according to the purpose of suspension:uterine suspension 69.22 or vaginal suspension 70.77/70.78.However,the suspension of pelvic fascia tendon arch for cystocele belongs to transvaginal paravaginal repair,not suspension,according to literature review.Thus,the code should be classified as 70.51 cystocele repair.The coding difficulty of hysterovaginal prolapse suspension lies in the need to deeply grasp the essence and connotation of clinical suspension,and then convert the clinical operation name into the classified operation name.Therefore,when coding for hysterovaginal prolapse suspension,it is not only necessary to read the surgical records in detail but also to communicate extensively with clinicians and coding peers,carefully search for coding,and consult literature to obtain accurate ICD-9-CM-3 coding.